Peer2Peer: Evolving Revolution – Brief Overview

sugarmanAbout the author:  Michael Sugarman.  Honored by American Speech and Hearing Association, International Fluency Association, National Stuttering Association, International Stuttering Association and Stutterers Hall of Fame. Wrote “Peer Counseling and Self Help Group Facilitation for People who Stutter” and “Self Help Workbook for People who Stutter” and various articles on how people change and peer activities.

“Who then can softly bind up the wound of another as he who has the same wound himself,” Thomas Jefferson, Third President of the United States, Person who Stutters (PWS)


People who stutter (PWS) help each other by listening, sharing common experiences, exploring options and giving support. Settings include one to one communication, workshops, conferences and support groups. PWS can relate and consequently offer empathy and validation. They have experienced similar life interactions and are able to offer practical advice.  By working together, they create a sense of community.

There are hundreds of studies which examine the effects of peer to peer (peer2peer) relationships on healing.  The studies highlighted below were selected because they provide good examples of professional and peer led communication across a variety of settings – one on one, small groups, and internet discussion groups.  As well, these studies show correlations between peer support and increased emotional wellbeing, development of coping strategies and problem solving skills, improved quality of life and social functioning, enhanced self esteem, reduced depression and anxiety, and the development of a strong sense of community, including lasting friendships.

Peer2peer support studies have provided helpful information for participants who experience mental health issues or chronic disease, addressing many of the social and emotional concerns that individuals face.  However, there are far fewer studies that involve PWS and the impact of peer2peer activities on fluency, coping mechanisms and increased quality of life.  These realms – the physical manifestation of the condition versus the social and emotional aspects – are intertwined.  The point of this paper is twofold, first, to promote the use and training of PWS as peer counselors, trainers and leaders to enhance the quality of life for PWS and second, to encourage more research about the impact of peer2peer experiences on PWS.

RESEARCH (Not About Stuttering)

  • Early research of drop-in centers run by and for psychiatric consumers found that participants experienced an increased quality of life as well as enhanced social support and problem solving skills   (Mowbray & Tan, 1993).
  • Mental health self help groups, an integral part of Tennessee’s Peer Support Center programs have been shown to decrease symptoms, increase coping skills and increase life satisfaction (Davidson et. al.,1999; Chamberlain et. al.,1996, Humphreys 1997; Raiff 1984).
  • One to one peer support with people who have co-occurring disorders of mental illness and substance use was found to result in fewer hospitalizations, improved social functioning, reduced substance use and improved quality of life among participants (Klein, Cnaan & Whitecraft, 1998).
  • Widows and widowers over age 50 who participated in bereavement and self help groups experienced less depression and grief than nonparticipants when participated in groups for longer than 8 weeks (Caserta & Lund 1993).
  • Four bereaved mothers, who had a child died, used an internet discussion group and received emotional, cognitive and community support. These mothers developed a strong sense of community and lasting friendship (Aho, Paavilainen & Kaunonen 2012).
  • Highly involved members of Recovery, a self help group for former mental health patients, reported no more anxiety about their health than did the general population. Members who had participated for two years or more had the lowest levels of worry and highest levels of satisfaction with their health (Raiff 1984).


  • A 2009 survey by the National Stuttering Association (NSA), found that stuttering support makes a difference. 1,235 people responded, including 686 adults and 31 teens who stutter, 164 parents of children who stutter and 354 speech language pathologists.  People who participate in NSA Association local chapters or national conferences report fewer negative effects of stuttering and more successful speech therapy than those who do not. Support groups help people improve self-confidence and develop positive attitudes about speaking and stuttering.  (McClure & Tetnowski, 2010)
  • Twelve participants were studied who attended self-help conference(s) to learn the potential utility in stuttering management. The experience by having attended a self help conference(s) for PWS helped minimize negative impact that stuttering can have on daily functions and helped to communicate more easily, increase social activity and promoted ‘openness ‘ on stuttering.(Trichon & Tetnowski 2011).

Conclusion and Benefits of Peer2Peer Support

The focus of peer2peer is to build a relationship of trust, reduce stigma, and increase acceptance and coping strategies.  Often people who live with stuttering participate in groups to find fluency.  This single purpose can mask the potential greater benefits of peer2peer groups and interactions — a better quality of life.  More studies about the positive effects of peer2peer interactions are needed.  In addition, PWS may want to look at peer2peer ideas used in other fields to see if there are effective techniques from which to learn.


Aho, A., Paavilainen, E., Kaaunonen, M. (2012) “Mothers’ experiences of peer support via an internet discussion forum after the death of a child.” Scandinavian Journal of Caring Sciences. Vol. 26. Issue 3.

Caserta, M.S. and Lund D.A. (1993). Intrapersonal Resources and the Effectiveness of Self help groups for Bereaved Older Adults. Gerontologist 33 (5) 619 – 629.

Chamberlin, J. Rogers, E.S. & Ellison, M.L. (1996) Self help programs: A description of their characteristics and their members. Psychiatric Rehabilitation Journal 19, 33 -42.

Davidson, L. Chinman, M. M. Kloos, B., Weingarten, R. Stayner, D. & Tebes, and J.K. (1990 Peer support among individuals among individiuduals with severe mental illness: A review of evidence. Clinical Psychology: Science and Practice, 6 (2) 165 – 187.

Humphreys, K. (1997) Individual and social benefits of mutual aid self help groups. Social Policy, 27, 13 – 19.

Klein, A.R., Cnaan, R.A. & Whitecraft, J. (1998). Significance of peer social support with dually diagnosed clients: Findings from a pilot study. Research on Social Work Practice. 8, 529 – 551.

McClure, J. & Tetnowski, J.A. (2010) Experience of people who stutter-  National Stuttering Association 2009 survey. Poster presentation at the annual conference of the American Speech-Language- Hearing Association, Philadelphia, PA.   Online http//

Mowbray, C.T. & Tan, C. (1993). Consumer-operated drop in centers run by and for psychiatric consumers: Evaluation of operations and impact. Journal of Mental Health Administration, 20, 8 -19.

Mead, S., MacNeil, C. (2006) “Peer Support: What makes it Unique?” International Journal of Psychosocial Rehabilitation 10 (2) 29 – 37

Raiff, N.R. (1984) “Some health related outcomes of Self help participation.” Chapter 14 in The Self Help Revolution, edited by Alan Gartner and Frank Riessman. New York: Human Science Press.

Trichon, M., & Tetnowski, J.A. (2011). Self help conferences for people who stutter. A qualitative investigation.  Journal of Fluency Disorders, 39, 290 – 295.

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Peer2Peer: Evolving Revolution – Brief Overview — 31 Comments

  1. Hello Michael — thank you so much for your observations on the benefits of peer-to-peer support. I have a 17-year old son who stutters (see my ISAD submission “The Right Time to Bring Out the Stickers.”) He has always been reticent to connecting with others – teens or adults – who stutter. He insists that he wants friends based on mutual interest, not based on the fact that they stutter. I get this, and fortunately he has lots of friends. I suspect that shame plays a role in his reticence. He also struggles with misophonia and just recently connected with others about this and found it very helpful. So who knows? I leave it up to him…but I know so many who have really gained from these connections. Thank you again for your insights…

    • Connecting with others is so important..a good sense of not being alone. Your son may want to consider attending friends or NSA conference. Hope to meet at one of the future conferences.

      • I agree with you that more research in this area is needed. While it could be beneficial, do you have any suggestions on how to motivate PWS to participate in support groups or talk openly about their stutter with others. I can see how shame, embarrassment and pride could get in the way for some PWS, but as an SLP would like to provide clients with these sorts of opportunities early on in order to aid the client in accepting their stutter and finding their own voice.


  2. Michael,
    Thank you for your research on peer2peer relationships. I have never heard of this exact term, but it makes perfect sense. It is clear that those who stutter need to have people in their life that can understand what they are going through. While they might not know exactly how each other is feeling, at least they have some type of common ground. I really enjoyed reading about your research and I hope you find out more as it pertains to people who stutter!

    • Thank you for your kind comments. I, too hope there will be more research in this area.

  3. A good article. I hope that in one way or another you keep on contributing to the NSA.

  4. Thank you for this information. I am a graduate student of Speech and Language Pathology at Idaho State University and understanding what can positively impact the quality of life and enhance the fluency of my clients in very important to me. Thank you for your perspective and time researching this subject.
    Summer Stout-Bloyer
    Idaho State University Graduate Student

  5. Michael,

    I appreciated the information provided in a concise manner in this paper. I especially pondered your statement: “Often people who live with stuttering participate in groups to find fluency. This single purpose can mask the potential greater benefits of peer2peer groups and interactions — a better quality of life”. I think this is so true. It seems there is so much more satisfaction available beyond “fluency” for people who stutter. This is a concept that can be applied to anything a person desires to overcome – such as procrastination, athletic deficits, etc. A better quality of life is the bottom line, not just achieving perfection with a certain skill.

    Thank you for the reminder,
    Renee R., graduate student
    Idaho State University

  6. Micheal,

    Thank you so much for bringing this topic to all of our attention. As a high school student, I used to attend peer leadership training, which basically taught me how to help peers that were having issues with one another come to a solution. I joined this club because I think that most people appreciate their peers perspective over an authority figure.

    And as a future SLP, I have learned that therapy for someone who stutters should incorporate counseling and be focused around people being comfortable with their speech. I think that having a peer involved in treatment is a great way to foster self acceptance, the same way peers make great facilitators.

    Again thank you!


  7. Michael,

    Thank you so much for your informative post on the importance of peer-to-peer relationships. Reading about the way you described peer-to-peer support is reminiscent of what I have learned throughout my studies in communication disorders. When you said, “the physical manifestation of the condition versus the social and emotional aspects – are intertwined,” I was reminded of the portion of our course which dealt with counseling strategies.

    The question I have for you is, how would you suggest encouraging a client who stutters to engage in peer-to-peer group interactions?


    Samantha N.

    • Hello Samantha,

      Thank you for your questions. PWS are able to attend conferences, Internet support, or attend peer groups. National stuttering assn. &. Friends who stutter r both organizations address this issues.


  8. Michael,

    Thank you for sharing this insightful article on the significance of peer-to-peer interactions. Throughout my life I have seen first hand the importance of being able to relate to other peers who perhaps were going through similar issues. As a future clinician, I very much understand how valuable it would be for a person who stutters to be able to share their thoughts and feelings with others who can relate to their experiences.

    As a future SLP, how would you suggest that my future colleagues and I increase awareness of the importance of peer-to-peer interactions?

    Thanks so much,


  9. Thank you. And the answer is yes by attending national stuttering association or friends who stutter conferences. Good luck to your future endeavors.


  10. Michael,
    Thank you so much for writing this paper and really going off the theme of supporting each other. My current client would exponentially benefit from a peer group and I have been looking into setting one up. My question is how do you advertise or organize a group in a rural area and when a group is established, do you recommend weekly, monthly, bi-monthly? I am just curious about the start up process.

    Thank you again!
    Western Carolina University

    • Hello Abby,

      I suggest u to go to national stuttering association on support groups.

      Good question about how often. If u host on campus and have students 2 x a month versus generalized public1 x a month. Good luck, Mike

      • Thank you very much for your reply! I am looking into it now. In your experience, is it okay to have a wide variety of people of different ages and stuttering severity level? I’m worried about the cohesion of my future group.
        Thank you again!

  11. Michael,

    Your article was very intriguing and I appreciate your perspective on the issue. I think the comparison with peer support around issues not related to stuttering is very relevant. My question for you is…when I hear peer, I think of someone around the same age. Do you think this is a requirement for the success of peer to peer interaction or do you think age is irrelevant? Also, do you think the peer to peer interaction would be as beneficial if the CWS was involved in a peer group with trained peers who do not stutter? Just wondering as living in a rural area, it may be difficult to find a group of CWS around the same age?


    • Try to contact NSA or friends who stutter both have really good resources to assist you.
      If the CWS can make it to a conference. It’s awesome.


  12. Micheal, great paper and great ideas. Peer support and counseling is so important – for all issues as you have pointed out.
    I think peer2peer support is expecially important for women who stutter. Many women who stutter have never met another woman who stutters, so the whole idea of peer2peer support would be greatly beneficial.
    Do you think it could woek well virtually as well as in real time?
    Thanks for all you do.

    • Thank you Pam. I feel its vital for folks to connect. Look forward to catching up with you at one of the conferences.


  13. Michael,

    I absolutely love the term you use “peer2peer” – I’ve never heard of it before, but I like the support it brings. Being able to relate and connect with others is so important and so relevant to human nature. It let’s us know we are not alone!

    My question to you is: In regards to peer2peer activities, how do you design activities to be relevant, well planned, challenging, and enjoyable for each member? If the members have different personal goals, can you personalize the activities to fit each person’s needs?

    Thank you,
    Christie Driscoll
    Graduate Student in Communication Sciences and Disorders
    Western Carolina University
    Cullowhee, NC

  14. Hello,

    Go the national stuttering association website under support groups. You’ll find resources to help u.

    Good luck in becoming a therapist. All the best,

  15. Hello Michael,
    Thank you for sharing information and research on peer2peer interactions. As a graduate student in speech language pathology, I found the information you presented thought provoking. I feel like you indicated the benefit of peer2peer interaction addressing several of the emotions that PWS encounter by “improved quality of life and social functioning, enhanced self esteem, development of coping mechanisms, etc.” Although more research is indicated with PWS, do you feel like there are any downsides to using peer2peer interactions with PWS?

    • Hello,

      One downsize — if a peer is not able to focus on issues being discussed and dominates the interchange.
      Second downsize—in the mental health community there is a effort to train peer counselors. The stuttering community is not there, yet.